How vision, visuals, and visualization represent levels of learning

Marilla Svinicki, PhD
Clinical Education Center at University Medical Center Brackenridge, Austin
The University of Texas at Austin

Vision is a powerful tool for teaching. It touches the learning process at many levels, and has many meanings. The goal of this article is to point out the ways that vision is and can be used to influence student learning. I have selected four different levels at which we can think about the role of vision in learning and have organized the subject matter around those four levels. The levels are vision as: 1) information, 2) organization, 3) conjuration, and 4) inspiration.

Vision as information

In an introduction to an issue on visualization in medicine, Parvati Dev explores the many ways in which medical education is advanced through the use of visual images, and includes anatomical drawings, radiographic images, CAT scans and MRIs, and computer simulations of surgical procedures as examples.¹ A picture really is worth a thousand words, from the perspective of information transmission. In fact, a single picture presents a whole array of information simultaneously, whereas descriptions present information sequentially. Simultaneous presentation means that all the components of information can be linked to all the rest of the components at the same time. Sequential presentation means that information must be held in working memory until all the rest of the information is delivered. Unfortunately our working memory has a limit on how long it can hold information and how much information it can hold. It’s quite possible that by the time all the information has been delivered, the first bits have been lost, and you’re left with the “gist” of the information rather than its entirety.

In visual presentation, however, you have the whole of the information at once available for scanning and sorting. Tufte,an expert in the use of visual presentation, says, "Graphics reveal (emphasis in the original) data."² Very little strain is placed on working memory as a result. You can glance at a visual presentation of information and without much effort focus on the important ideas. A good example of this is the difference between data presented as a figure versus data presented in a table. A table must be read, while a figure presenting the same information (such as a pie chart or bar chart) almost compels the viewer to make the desired comparisons instantly. Therefore, if the function of the data is to quickly facilitate comprehension of the relationship of the components to one another, a graphic presentation is much more effective, both for initial comprehension and eventual recall. Which brings us to our next use of vision.

Vision as organization

Visuals are particularly useful for teaching because they invite, indeed demand, relational learning. An important support for learning is organization of information because the mind stores information as a network of relationships.³ The better organized the network; the easier it is for the learner to retrieve the information at a later date. In fact, research on expertise shows that experts not only know more information, but they have that information structured in a way that provides ease of retrieval and use in problem solving. The mental models of those who are experts on how things are structured show that these experts are able to recall storehouses of information by reconstructing their mental picture of how the system is structured.^4,5 Information that is presented in such an organized fashion is easier to connect to that structure and, therefore, easier to remember. For example, charts and concept maps representing the network structure are very powerful tools for directing information storage by a learner. If the organization is evident, the learner will use that organizational structure as the networking strategy for storage in memory. In fact in the absence of inherent organization in the information being learned, a learner will impose his or her own organization on it. This action can result in misunderstandings or misconceptions, which, once solidified, are hard to overcome.⁶

An example of a visual organization structure is the concept map. This interconnected set of circles and arrows shows main ideas and their subcomponents as nodes and shows relationships as lines drawn between the ideas. Another commonly used visual organizer is the flow chart, which in addition to main ideas and relationships, can show sequences and decision points.

My favorite form of visual organizer is called a “comparative organizer,” which consists of a chart made up of rows and columns that represent the key variables in a set of information. Picture a three-by-three table, with the two columns headed “pro” and “con.” The rows are two proposed solutions to a problem: proposed solution A and proposed solution B. The task is to fill in the squares that represent the pros and cons of each solution. This very simple visual speaks very powerfully to the learner. It asserts that each solution has pros and cons to it, and it is the learner’s challenge to figure out what they are. Such a chart can be used very effectively to organize a lecture, or to evaluate the options in a case presentation. For a lecture, the lecturer can fill in the cells as he or she proceeds. For a case presentation, as points are raised, they can be placed within the appropriate cells of the organizer.

The aforementioned comparative organizer is a powerful learning tool for the learner as well as the instructor. In my own classes I use the format so frequently that my students have begun to anticipate what information will be used as the basis for the next organizer in class. In other words, they are starting to think about the content in terms of that comparative structure rather than as individual bits of information. What more can we ask of learners than that they learn to think structurally about the content?

Vision as conjuration

You may be asking yourself, “what is conjuration?” The word implies the conjuring of additional information not immediately presented by the image that is shown. We “conjure” up an image of our friend as we try to describe her features, coloring, expression, and so on. In teaching, we conjure meaning based on what we actually present. For example, visuals imply meaning, but the meaning that is inferred is based on the learner. A classic example of this type of visual conjuring is the famous Rorschach test from psychoanalysis, known to more of us as the “inkblot” test. The theory is that whatever the person sees in the inkblot is more a reflection of his or her inner thoughts and experiences. The blots have no particular meaning; they draw out of the observer whatever he or she has hidden in memory or the subconscious. The same can be said of any ambiguous picture; we see what we are rather than what we actually see.

We can use this phenomenon in teaching by asking learners to respond to or describe the content of ambiguous images (or cases) as a way of getting them to divulge their understanding or misunderstanding of a concept. We can show them an unclear picture of a patient's condition and ask them to speculate on what is happening. This use of vision is particularly interesting as a way of getting learners to move beyond memorization and into conjecture or problem solving. What the learners say they see then allows us as educators to diagnose what they know or think.

Vision as inspiration

Inspiration provides another possible way to interpret the term “vision.” This particular interpretation of “vision” is the idea of imagination. What vision do students have of themselves now and for the future? With this use of vision, we invite our students to look ahead and set goals for themselves, for their future, and for society. A very critical step in human development is the emergence of the ability to imagine alternative selves. How do our students see themselves and their role in the physician/patient relationship? That vision will have a great influence on their ability to understand their patients' needs and state of mind and as a result be able to treat the whole patient. Without the ability to imagine what else is possible, an individual is stuck accepting the present or remaining at the mercy of an outmoded and inappropriate behavior pattern.

As teachers, we want our students to make conscious choices rather than allowing others to choose for them. To do this, students must create their own alternatives; they must be able to imagine a vision for themselves. That vision can then become the roadmap they follow to achieve their goals. We can offer them alternative visions of themselves which they might not have seen and can help them assess those alternatives and make plans to pursue them. And we can be clear about our own visions for them now and for the future.

References

Dev P. Imaging and Visualization in Medical Education. IEEE Computer Graphics and Applications, May/June 1999.
Tufte E. The Visual Display of Quantitative Information, 2nd ed. Graphics Press; 2001.
Bransford J, Brown A, Cocking R. How People Learn: Brain, mind, experience, and school. Washington, DC: National Academy Press; 1999.
Gott S, Lesgold A. Competence in the Workplace: How cognitive performance models and situated instruction can accelerate skill acquisition. Advances in Instructional Psychology, Vol. 5. Lawrence Erlbaum Publisher; 2000.
Norman G, Eva K, Brooks L, Hamstra S. Expertise in medicine and surgery. The Cambridge Handbook of Expertise and Expert Performance. Cambridge University Press; 2006.
Patel V, Kaufman D, Arocha J. Conceptual change in the biomedical and health sciences domain. Advances in Instructional Psychology, Vol. 5. Lawrence Erlbaum Publisher; 2000.

Online October 29, 2009